Microsurgical Chest Wall Reconstruction After Oncologic Resections

ABSTRACT

Defect reconstruction after radical oncologic resection of malignant chest wall tumors requires adequate soft tissue reconstruction with function, stability, integrity, and an aesthetically acceptable result of the chest wall. The purpose of this article is to describe possible reconstructive microsurgical pathways after full-thickness oncologic resections of the chest wall. Several reliable free flaps are described, and morbidity and mortality rates of patients are discussed.

KEYWORDS

Chest wall - free flap - malignant tumor - full-thickness defect - reconstructive microsurgery

REFERENCES

• 1 Sullivan S R, Truxillo T M, Mann G N, Isik F F. Utility of the free deep inferior epigastric perforator flap in chest wall reconstruction.  Breast J. 2007;  13 50-54
• 2 Liapakis I E, Korkolis D, Papadopoulos O et al.. Reconstruction of the chest wall.  J BUON. 2008;  13 185-191
• 3 Cordeiro P G, Santamaria E, Hidalgo D. The role of microsurgery in reconstruction of oncologic chest wall defects.  Plast Reconstr Surg. 2001;  108 1924-1930
• 4 Erdmann D, Küntscher M, Petracic A et al.. Plastic surgery coverage of osteocutaneous defects of the sternum area with the vertical and transversal rectus abdominis muscle (VRAM/TRAM) flap.  Chirurg. 2000;  71 1156-1160
• 5 Küntscher M V, Erdmann D, Homann H H, Steinau H U, Levin S L, Germann G. The concept of fillet flaps: classification, indications, and analysis of their clinical value.  Plast Reconstr Surg. 2001;  108 885-896
• 6 Küntscher M V, Erdmann D, Strametz S, Sauerbier M, Germann G, Levin L S. The use of fillet flaps in upper extremity and shoulder reconstruction.  Chirurg. 2002;  73 1019-1024
• 7 Engel H, Pelzer M, Sauerbier M, Germann G, Heitmann C. An innovative treatment concept for free flap reconstruction of complex central chest wall defects—the cephalic-thoraco-acromial (CTA) loop.  Microsurgery. 2007;  27 481-486
• 8 Daigeler A, Druecke D, Hakimi M et al.. Reconstruction of the thoracic wall—long-term follow-up including pulmonary function tests.  Langenbecks Arch Surg. 2009;  394 705-715
• 9 Santillan A A, Kiluk J V, Cox J M et al.. Outcomes of locoregional recurrence after surgical chest wall resection and reconstruction for breast cancer.  Ann Surg Oncol. 2008;  15 1322-1329
• 10 al-Kattan K M, Breach N M, Kaplan D K, Goldstraw P. Soft-tissue reconstruction in thoracic surgery.  Ann Thorac Surg. 1995;  60 1372-1375
• 11 Anderson B O, Burt M E. Chest wall neoplasms and their management.  Ann Thorac Surg. 1994;  58 1774-1781
• 12 Pameijer C R, Smith D, McCahill L E, Bimston D N, Wagman L D, Ellenhorn J D. Full-thickness chest wall resection for recurrent breast carcinoma: an institutional review and meta-analysis.  Am Surg. 2005;  71 711-715
• 13 Warzelhan J, Stoelben E, Imdahl A, Hasse J. Results in surgery for primary and metastatic chest wall tumors.  Eur J Cardiothorac Surg. 2001;  19 584-588
• 14 Henderson M A, Burt J D, Jenner D, Crookes P, Bennett R C. Radical surgery with omental flap for uncontrolled locally recurrent breast cancer.  ANZ J Surg. 2001;  71 675-679
• 15 Friedel G, Kuipers T, Dippon J et al.. Full-thickness resection with myocutaneous flap reconstruction for locally recurrent breast cancer.  Ann Thorac Surg. 2008;  85 1894-1900
• 16 Faneyte I F, Rutgers E J, Zoetmulder F A. Chest wall resection in the treatment of locally recurrent breast carcinoma: indications and outcome for 44 patients.  Cancer. 1997;  80 886-891
• 17 Riedel K, Kremer T, Hoffmann H et al.. Plastic surgical reconstruction of extensive thoracic wall defects after oncologic resection.  Chirurg. 2008;  79 164-174